How is this not torture?

Parmen, V. (2014) ‘Electroacupuncture Analgesia in a Rabbit Ovariohysterectomy’, Journal of Acupuncture and Meridian Studies, vol. 7, no. 1, pp. 15-24. (Links available at RationalVetMed.org)

To be frank, this is one of the most cruel papers on any subject I have come across. I was so utterly shocked by it I couldn’t believe what I was reading and hoped I had misunderstood what the experimenters had done here in the name of acupuncture research. So I asked Martin Whitehead, of the Campaign for Rational Veterinary Medicine to take a look for me. It turns out I hadn’t misunderstood, the authors of this paper had actually operated on rabbits, surgically opening their abdomens and removing their uterus and ovaries while they were fully conscious and tied down to a metal frame, without the benefit of any form of anaesthetic or pain relief, while at the same time administering electric shocks to them and claiming this was “acupuncture anaesthesia” (a discredited technique which is illegal in many countries). As a colleague said when I mentioned this paper to her, “how is that not torture?

Comment from Dr Martin Whitehead:

This paper makes me feel queasy. That it had ethical approval from the university make me feel even more queasy.

It is clear that the acupuncture group rabbits were given no anaesthesia or analgesia (other than any resulting from the acupuncture and unknown-intensity electric currents passing through the rabbit).

The neuroleptanalgesia group were given ketamine (no analgesic action) and xylazine (which does have some analgesic action) but no other analgesia.

From Table 1 it appears that the rabbits were tied down in the metal device shown in Fig. 1 and receiving the electroacupuncture for at least 42-55 mins. Even if there was no surgery, not a nice thing to do to a rabbit – assuming they are conscious throughout, which certainly seems to have been the case.

In section 2.3. it says “the intensity of the electric current stimulation was slowly increased from zero until the animals showed signs of discomfort and twitching. After that, the intensity was slowly increased to 4, 6, and finally to 8 V for the abdominal site; for dorsal stimulation, the intensity was slowly increased to 2.2 V and then to 2.7 V.” That sounds grim.

Only voltages are stated, with no idea what current was being used (e.g., for comparison with a TENS machine), so it is not possible to tell what sort of effect this current would have on nerves or muscles.

From Fig. 3, the heart rate was lower in the electroacupuncture group, except at the time of actual surgery when it was much higher, which is not a promising sign. The respiratory rate was far higher in the electroacupuncture group before and during surgery, also not a promising sign. Those findings could be interpreted as indicating that the electroacupuncture rabbits were feeling more pain than the neuroleptanalgesia rabbits.

The one scrap of comfort I get is the very last sentence of the Results section – there was no “screaming related to stress or pain”. I hope that means there was no screaming at all.

So, the next time someone says, with regard to Complementary and Alternative Veterinary Medicine, “where’s the harm”, you might like to point them to this paper. How delusional and a priori convinced of the merits of acupuncture, must the authors be to think this was, in any way, a humane procedure?

Homeopathy, the NHS and BBC Radio Bristol

Campaign for Rational Veterinary Medicine’s Danny Chambers has just given a very strong interview on the John Darvil show, on BBC Radio Bristol on Wednesday 16th August, 2017.

The subject was the availability of homeopathy on the NHS and Danny gave a succinct explanation why its continuing endorsement by the NHS is wrong on every level. It’s a waste of money, undermines real medicine and, bottom line, puts lives at risk. For instance, this recent paper demonstrates that cancer patients who opt to use CAM treatments such as homeopathy are up to 5 times more likely to die within 5 years of diagnosis as a result of their cancer.

The link to Danny’s interview is here: www.bbc.co.uk/programmes/p05b5096 (the relevant section starts about 7 minutes 30 seconds in) and it’s well worth a listen as a robust and measured counter to the arguments of the homeopathic lobby. It’s going to be available until around the 16th September.

Magical Thinking and the ‘Tongue Worm’

Faustino-Rocha, A.I., Henriques, N. and Venâncio, C. (2017) ‘Lyssa lingualis: debunking the myth of the “tongue worm”‘, European Journal of Companion Animal
Practice, vol. 27, no. 1, pp. 63-66. [Link]

There is a fascinating article in the latest edition of the European Journal of Companion Animal Practice concerning a phenomenon I hadn’t been previously aware of.

Apparently in the days of Ancient Greece it was believed that rabies was caused by a worm which lived in a dog’s tongue. This structure can be seen as a pale streak in the midline of the underside of many dogs’ tongues and is referred to as the Lyssa (Lyssa was the goddess of madness); it does indeed look a little like a worm. The ancient remedy to ‘cure’ rabies was to remove this supposed parasite after which the dog would allegedly recover and then the Lyssa itself (which would ‘wriggle’ convincingly after removal) could be used in remedies to ‘cure’ humans who had been bitten. This was performed on the dog using a blade and without any sort of sedation or anaesthetic. Who would be mad enough to perform this procedure in a rabid dog I have no idea, but it must have been agony for the dog.

So far this sounds like nothing more than a piece of interesting, if gruesome, historical information. That is until you realise that this appalling procedure is still carried out in parts of Europe today as a supposed cure for a variety of diseases including rabies, but now also distemper and parvo-virus, still with no anaesthetic.

It turns out the Lyssa is a perfectly normal anatomic structure, possessed by all dogs, it is composed of muscle and fat. Its precise function is unknown but it’s easy to imagine it might be part of the supporting structure of the tongue. What it most emphatically is NOT, is a worm, it is part of the dog and removing it serves no purpose whatsoever. The authors of the paper describe the procedure as ‘witchcraft’ and inform us it is a criminal offence.

Just another example of magical thinking in the world of veterinary medicine (although I would hope the procedure isn’t carried out by actual veterinary surgeons) and how suffering can be caused in the name of wishful thinking.

This paper is a brilliant and simple example of how science can help counter superstition and barbarity.

A Cure for Cancer?

The website of the British Association of Homeopathic Veterinary Surgeons (BAHVS) features a case report in its ‘successful cases’ section, concerning a dog named Bedford (BAHVS, 2012). Bedford was diagnosed with a particularly nasty manifestation of a type of cancer, the squamous cell carcinoma, which appeared as a sizeable mass on top of his head, causing considerable pain and facial deformity.

The story continues, explaining Bedford’s owner, feeling conventional medicine had gone far enough, went on to seek homeopathic help, which was duly given, and to which he reportedly responded, eventually returning to his old self and able to enjoy life again, with no more problems.

From the photographs, it is clear the mass was initially large and painful, yet, after treatment, although the second photograph provided is from a slightly different angle, Bedford appears almost back to normal – the distortion of his brow and eyes seems to have gone and there is a keen look in his eyes.

Taken at face value (although the word ‘cure’, while present in the web address, is conspicuously absent from the account) this ‘successful case’ appears to support the position homeopathy can have profound, positive effects on cancer.

And what could be simpler? Dog gets cancer, dog is given homeopathy, dog recovers. Surely this must be convincing proof of the power of homeopathy?

I was curious to say the least when I first read Bedford’s story. My first thought, given what is known about homeopathy, was this story, as it stood, was unlikely to be true. Cancer Research UK, for instance, reports ‘there is no scientific or medical evidence [homeopathy] can prevent cancer or work as a cancer treatment’ (Cancer Research UK, 2015). Rather than dismiss it out of hand however, I wrote to the BAHVS and they were kind enough to send me Bedford’s clinical history.

On reading the notes, I discovered there was a significant gap in the account. It transpires, at the same time Bedford was receiving homeopathic treatment he was also being treated with robenacoxib, a drug of the non-steroidal anti-inflammatory (NSAID) group.

This class of drugs is well researched and is widely known to have anti-cancer properties, particularly in cases of squamous cell carcinoma (Hilovska et al, 2015). Yet, for whatever reason, the BAHVS had not seen fit to point out such a drug was being given. Other science-based medications – ‘strong opiates’ for instance – are referred to, yet the very one that might have had a real bearing on the case was not even mentioned (although I notice, on the current manifestation of the page, the acronym ‘NSAID’ has indeed appeared, albeit with no explanation as to its significance).

Assuming this might have been an inadvertent omission, I wrote back to BAHVS to explain the situation and suggest, in the interests of full disclosure, they might like to add a paragraph or two to the account describing the potential role of robenacoxib in this case. That way, readers would be able to make a properly balanced judgement about the case, since anyone reading it as it stood could be forgiven for incorrectly assuming the changes in Bedford’s cancer were solely the result of homeopathic treatment.

To my great disappointment, however, the BAHVS declined to make any change to the account, informing me in its reply ‘it is what it is’.

It is clear that ‘what it is’ is simply another example of the tendency of homeopaths to cherry-pick evidence to suit their preconceptions, even, as in this case, when it has been pointed out that by doing so they are misleading the public.

It has to be asked, if homeopathic practitioners are so confident about their chosen modality – despite the wealth of scientific literature which finds it is no more effective than placebo – what is it they have to fear about presenting a full and honest account of this case rather than the one that currently still stands?

References:

British Association of Homeopathic Veterinary Surgeons (BAHVS) (2012) Resolved Cancer Case 2 [Online]. Available at http://www.bahvs.com/cured-cancer-case-2/ (Accessed 24 May 2017).

Cancer Research UK (2015) Homeopathy [Online]. Available at http://www.cancerresearchuk.org/about-cancer/cancer-in-general/treatment/complementary-alternative-therapies/individual-therapies/homeopathy (Accessed 24 May 2017).

Hilovska, L., Jendzelovsky, R. and Fedorocko P. (2015) ‘Potency of non-steroidal anti-inflammatory drugs in chemotherapy’, Molecular and Clinical Oncology, vol. 3, no. 1, pp. 3–12, [Online]. Available at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4251142 (Accessed 24 May 2017).

Bogus Homeopathic Arguments – No. 1

The establishment is conspiring to suppress the truth about homeopathy!!!

Just consider for a moment what the implications of this claim are. In order for this to be true there would have to be a world wide conspiracy involving researchers at every level in government, universities, charitable institutions and private industry, pharmaceutical companies, medical and veterinary practitioners, nurses, midwives, journalist, marketing organisations and authors would all have to be working together to suppress the supposed convincing evidence that homeopathy works. To keep the truth under wraps there would have to be a massive level of coercion – bribes, bullying, threats and blackmail, none of which has ever been reported by anyone at any time.

The alternative is that general opinion is correct while a minority of homeopathic researchers and practitoners – all of whom have a vested interest of one sort or another – continue to claim that it works and support that position by using questionable data, cherry picking evidence and quoting trials which have been refuted many times in the past.

Just because “The Establishment” is big and faceless doesn’t mean it’s automatically wrong. In fact “The Establishment” is just a collection of ordinary people like you and me who would object strongly on allsorts of grounds if they believed that the truth was being systematically hidden. According to homeopathic bodies there are literally thousands of research papers which ‘prove’ homeopathy works. Furthermore, this is a system of medicine whose practitioners claim is gentle, side-effect free, safe and consistently effective, even in the most serious of diseases – heart disease, cancer, Ebola, HIV/AIDs, malaria. If both these claims were true then everyone and their granny in health care would be using it almost exclusively, what possible reason would there be not to. Yet still homeopathy remains marginalised and discredited, the province of science denialists and new-age cranks. Why? Because it simply doesn’t work, it is no different from giving a blank sugar pill.

Consider the real conspiracies that we do know about – “big business” has tried in the past to suppress the truth about the harm from asbestos and from smoking, the car industry for years blocked seat-belt and other safety legislation with bogus claims they would do more harm than good, the pesticide industry tried to hide the truth about the harmful effects of DDT. But in all these cases, even with the political and financial clout that the companies involved had, the truth finally came out in its entirety and in a very short space of time, a few decades at the most from suspicion being voiced to having it confirmed scientifically. By comparison homeopathy has been in existence for well over 200 years and there is still no good quality evidence that is in the slightest effective.

Drink up! Now you can breathe easy…

Nearly 20 years ago, Stephen Barrett, of the Complementary and Alternative Medicine watchdog ‘Quackwatch’ reported, ‘Various products referred to as “stabilized” or “aerobic oxygen”, are being marketed with claims that they can cure disease by increasing oxygen delivery to the cells’.

In his article Dr Barret went on to describe how these products were not only useless and unable to do what their promoters claimed but that even if they could somehow add oxygen to our blood-stream by drinking them (something humans would find impossible on account of not having gills) there is no such thing as ‘oxygen deficiency’ which causes disease anyway – suffocation yes, disease, no. In short, you can’t absorb oxygen from your gut and even if you could it would do you no good.

One such product was sold as ‘Vitamin O’ and the authorities became so concerned about it they took action. The Federal Trade Comission (FTC), charged with protecting consumers in the US, filed a complaint which alleged that two Washington companies (both controlled by the same person) had ‘falsely claimed that “Vitamin O” taken orally allows oxygen molecules to be absorbed through the gastrointestinal system [and] that “Vitamin O” prevents or treats life-threatening diseases and other ailments’.

In settlement, the defendants were obliged to pay $375,000 for ‘Consumer Redress’ and were prohibited ‘from making unsupported representations that: “Vitamin O” or any substantially similar product prevents or is an effective treatment for life-threatening diseases, including but not limited to, cancer, cardiovascular disease and pulmonary disease.

There is, it seems, nothing new under the sun. Fast forward to the present day and we find that ‘Aerobic Oxygen’ is still on sale from a number of suppliers including Amazon and Ebay as well as smaller outlets including ‘fully qualified veterinary surgeon’ Roger Meacock on his ‘Natural Healing Solutions’ website.

Like those who were selling the ‘substantially similar’ product ‘Vitamin O’ in 1999, today vendors of ‘Aerobic Oxygen’ claim it is ‘a new way of delivering extra oxygen to the body that is safe [and] convenient…’ and suggest that drinking a few drops of aerobic oxygen mixed in a glass of water bears comparison to the use of oxygen therapy, where gaseous oxygen is delivered through a mask or endotracheal tube to patients suffering respiratory compromise as a result of asthma or other lung disease.

Extensive use is made by Vitalox, the company run by UKIP politician Andrew Haigh which supplies ‘Aerobic Oxygen’, of questionable marketing techniques as their website first reports that (obviously) oxygen is needed for adequate cellular function and normal foetal development, and suggest oxygen might be associated with cancer and cellulite before switching tack to imply that by ‘boosting blood oxygen levels’, ‘Aerobic Oxygen’ can help. All this despite the fact there is no evidence ‘Aerobic Oxygen’ can have any effect on blood oxygen levels whatsoever and no mechanism by which it could. Of course, never at any point does anyone actually come out and say that ‘Aerobic Oxygen’ can cure cancer, control cellulite, optimise cell function or anything else because they know full well such claims would be false. Roger Meacock comes close though on one page of his website when he states: ‘K9 Immunity and K9 Transfer Factor are part of Roger’s standard dog cancer treatment protocol… Other additional supplements such as Aerobic Oxygen may help according to [sic] the type and aggressive nature of the cancer’.

Now, as if all these dubious claims and insinuations weren’t enough, according to an article by science writer Tom Chivers on BuzzFeed.com, chemist Dr Dan Cornwell of King’s College London has analysed ‘Aerobic Oxygen’ and discovered it is more or less indistinguishable from plain household bleach. To quote Dr Cornwell, ‘Aerobic Oxygen’ is ‘definitely some powerful bleach-like alkali’.

This shouldn’t come as too much of a surprise really after reading the websites of those good folks who sell it, as we learn ‘Aerobic Oxygen’ ‘… was developed for NASA for water purification purposes’ (just like bleach) and that ‘it will kill anaerobic bacteria, fungi, viruses and parasites…’ (also, just like bleach).

The analysis and other information regarding ‘Aerobic Oxygen’ has been passed to the UK’s Food Standards Agency and is currently under review by their National Food Crime Unit. I wonder if they’ve got the phone number of the FTC?

Homeopaths – poor losers

Bodey, A.L., Almond, C.J. and Holmes, M.A. (2017) ‘Double-blinded randomised placebo-controlled clinical trial of individualised homeopathic treatment of hyperthyroid cats’, Veterinary Record, vol 180, p. 377 (doi:10.1136/vr.104007). [Visit RationalVetMed.org for full links]

Abstract… There were no statistically significant differences in the changes seen between the two treatment arms following placebo or homeopathic treatment… or between the means of each parameter for either treatment arm before and after placebo or homeopathic treatment…  The results of this study failed to provide any evidence of the efficacy of homeopathic treatment of feline hyperthyroidism.

§

Hyperthyroidism (an over-active thyroid gland) in cats is a nasty, insidious disease which, in a nutshell, turns the metabolism of affected cats up to eleven. Their heart starts to beat so fast it eventually fails, their energy consumption rockets so they develop a ravenous appetite, eating more food than ever before, yet they still lose weight. And they also get quite grumpy as a rule. But despite all this they can live untreated for a considerable while, although with serious quality of life issues.

Some homeopaths claim you can treat an overactive thyroid by using homeopathy or, more precisely, isopathy with nosodes prepared from ground up thyroid glands (which, by the way, is an example of ‘sympathetic magic’, along the lines of the medicine man spitting on the ground to bring rain or a voodoo priest sticking pins in an effigy of someone who is ill). These homeopaths are most charitably described as ‘mistaken’.

What happens when truly hyperthyroid cats are treated homeopathically (i.e. with nothing) is that they stuggle on for months and months with heart failure and weight loss, becoming increasingly uncomfortable and breathless yet all the time, like most cats, just appearing to sit around quietly rather than making a fuss, right up until the point they go into acute heart failure and die, often in some distress. And while this is happening the attending homeopath is either claiming success on the good days or claiming an ‘aggravation’ during the bad ones – ‘ever had your cat vaccinated, ever fed it commercially prepared cat food, ever given it any medicine, or flea or worm treatment? There you are then, it’s all your fault, it’s the toxins’, they’ll tell you as they trouser your hard-earned cash.

And it’s all nonsense – you cannot successfully treat an overactive thyroid with homeopathy or isopathy as this well conducted trial by statistical supremo Mark Holmes and crew shows.

Of course, the homeopaths are wingeing about it, as they always do when trials, no matter how well conducted, don’t give results they like, even when in this case homeopathic head honcho John Saxton personally gave his go ahead for the trial design.

The homeopathic practitioner, Chris Almond, who participated in the trial says he is expecting a hard time from his homeopathic colleagues – ‘I don’t think I am going to be very popular’ he complains in an article in the BSAVA Companion magazine. And then, in typical homeopathic fashion, the excuses start – having been a willing part of the trial for the whole six years it took to perform, cooperating at every stage and interpreting the answers from owners in response to an agreed questionnaire, once the results are published he suddenly changes his tune, ‘the quality of responses from clients in the questionnaire was often “pretty poor” and made it difficult for him to determine the best individualized treatment for each animal’. Furthermore, he has now decided ‘he was also uncomfortable with the three-week duration of therapy set in the trial protocol’ and, anyway (one can almost hear the stamping of tiny feet and the sound of toys being thrown out of prams by this stage), ‘the experience of participating in the study has shown him that the randomized controlled trial format is simply not suitable as a test of homeopathic methods’.

Well why didn’t he say something sooner, one might well ask? Could it be he was waiting just in case the results were favourable to homeopathy first, in which case the triumphalist cries from the vet homs would have been deafening? But that didn’t happen, the results were entirely in line with expectations and it looks like Mr Almond is currently being hung out to dry by his erstwhile colleagues for consorting with the devil and participating in a well run, methodologically robust trial along with two other veterinary surgeons who were completely independent of any vested interest. Really, what was he thinking!

I can do no better than to quote Andrew Bodey, the (conventional) veterinary practitioner whose idea it was to perform the trial in the first place, ‘If the purpose of your efforts is to justify your own opinions rather than to answer a legitimate question, then that is not going to work…

There’s no getting away from it, homeopaths are simply poor losers.

For full links to the original papers visit RationalVetMed.org.